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Mairinger E, Wessolly M, Buderath P, Borchert S, Henrich L, Mach P, Steinborn J, Kimming R, Jasani B, Schmid KW, Bankfalvi A, Mairinger FD. Tumor cell cytoplasmic metallothionein expression associates with differential tumor immunogenicity and prognostic outcome in high-grade serous ovarian carcinoma. Front Oncol 2023; 13:1252700. [PMID: 38023247 PMCID: PMC10663300 DOI: 10.3389/fonc.2023.1252700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background The underlying mechanism of high T-cell presence as a favorable prognostic factor in high-grade serous ovarian carcinoma (HGSOC) is not yet understood. In addition to immune cells, various cofactors are essential for immune processes. One of those are metallothioneins (MTs), metal-binding proteins comprising various isoforms. MTs play a role in tumor development and drug resistance. Moreover, MTs influence inflammatory processes by regulating zinc homeostasis. In particular, T-cell function and polarization are particularly susceptible to changes in zinc status. The aim of the present study was to investigate a possible role of MT-mediated immune response and its association with prognostic outcome in ovarian cancer. Methods A retrospective study was conducted on a clinically well-characterized cohort of 24 patients with HGSOC treated at the University Hospital of Essen. Gene expression patterns for anti-cancer immunogenicity-related targets were performed using the NanoString nCounter platform for digital gene expression analysis with the appurtenant PanCancer Immune Profiling panel, consisting of 770 targets and 30 reference genes. Tumor-associated immunohistochemical MT protein expression was evaluated using a semi-quantitative four-tier Immunohistochemistry (IHC) scoring. Results MT immunoexpression was detected in 43% (10/23) of all HGSOC samples. MT immunoexpression levels showed a significant association to survival, leading to prolonged progression-free and overall survival in positively stained tumors. Furthermore, T-cell receptor signaling gene signature showed a strong activation in MT-positive tumors. Activated downstream signaling cascades resulting in elevated interferon-gamma expression with a shift in the balance between T helper cells (TH1 and TH2) could be observed in the MT-positive subgroup. In addition, a higher expression pattern of perforin and several granzymes could be detected, overall suggestive of acute, targeted anti-cancer immune response in MT-positive samples. Conclusion This is the first study combining broad, digital mRNA screening of anti-tumor immune response-associated genes and their relation to MT-I/II in ovarian cancer. MT overexpression is associated with molecular characteristics of an anti-cancer immune response and is a strong prognostic marker in ovarian HGSOC. The observed immune cell activation associated with tumor MT expression comprises but is not limited to T cells and natural killer cells.
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Affiliation(s)
- Elena Mairinger
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - Michael Wessolly
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Paul Buderath
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Sabrina Borchert
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - Larissa Henrich
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - Pawel Mach
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Julia Steinborn
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - Rainer Kimming
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Bharat Jasani
- Department of Pathology, Targos - A Discovery Life Sciences Company, Kassel, Germany
| | | | - Agnes Bankfalvi
- Institute of Pathology, University Hospital Essen, Essen, Germany
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Wyrich M, Ohlig H, Wessolly M, Mairinger E, Steinborn J, Brcic L, Hegedus B, Hager T, Greimelmaier K, Wohlschlaeger J, Mairinger FD, Borchert S. Induction of metallothionein expression by supplementation of zinc induces resistance against platinum-based treatment in malignant pleural mesothelioma. Transl Cancer Res 2023; 12:1929-1936. [PMID: 37701096 PMCID: PMC10493783 DOI: 10.21037/tcr-22-2651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/11/2023] [Indexed: 09/14/2023]
Abstract
Background Malignant pleural mesothelioma (MPM) is an aggressive tumor with a dismal prognosis. Currently, multimodality treatment including chemotherapy with cisplatin or carboplatin in combination with pemetrexed offers the best options. Detoxification of heavy metals in the cell by metallothioneins (MT) is associated with early failure to platin-based chemotherapy. The induction of MTs gene expression or its enzyme results in saturation by exposure to metal ions such as zinc or cadmium. Its therapeutically effect is still not analyzed in depth. Methods In our study, we investigated three MPM cell lines and one fibroblast cell line in the course of cisplatin treatment and supplementation of zinc. Cell state analyses via an enzyme-activity based assay were performed. With this, we were able to analyze apoptosis, necrosis and viability of cells. Additionally, we tested treated cells for changes in metallothionein IIA (MT2A) expression by using quantitative realtime polymerase chain reaction. Results Zinc supplementation induces gene expression of MT2A. Overall, a zinc dose-dependent induction of apoptosis under platin-based treatment could be observed. This effect could be verified in all analyzed cell lines in varying intensity. Conclusions MT expression is induced by zinc in a dose-dependent manner and inhibits a successful cisplatin therapy. Therefore, heavy metal exposure during cisplatin therapy, e.g., via cigarette smoke, might be an important factor. This should be considered in further therapeutic approaches.
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Affiliation(s)
- Martine Wyrich
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Henning Ohlig
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Wessolly
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Elena Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Balazs Hegedus
- Ruhrlandklinik, West German Lung Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Hager
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Pathology, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | | | - Jeremias Wohlschlaeger
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Pathology, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - Fabian D. Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Sabrina Borchert
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
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Greimelmaier K, Klopp N, Mairinger E, Wessolly M, Borchert S, Steinborn J, Schmid KW, Wohlschlaeger J, Mairinger FD. Fibroblast activation protein-α expression in fibroblasts is common in the tumor microenvironment of colorectal cancer and may serve as a therapeutic target. Pathol Oncol Res 2023; 29:1611163. [PMID: 37614665 PMCID: PMC10442481 DOI: 10.3389/pore.2023.1611163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023]
Abstract
Background: Colorectal cancer (CRC) is still one of the leading causes of cancer death worldwide, emphasizing the need for further diagnostic and therapeutic approaches. Cancer invasion and metastasis are affected by the tumor microenvironment (TME), with cancer-associated fibroblasts (CAF) being the predominant cellular component. An important marker for CAF is fibroblast activation protein-α (FAP) which has been evaluated as therapeutic target for, e.g., radioligand therapy. The aim of this study was to examine CRC regarding the FAP expression as a candidate for targeted therapy. Methods: 67 CRC, 24 adenomas, 18 tissue samples of inflammation sites and 28 non-neoplastic, non-inflammatory tissue samples of colonic mucosa were evaluated for immunohistochemical FAP expression of CAF in tissue microarrays. The results were correlated with clinicopathological data, tumor biology and concurrent expression of additional immunohistochemical parameters. Results: 53/67 (79%) CRC and 6/18 (33%) inflammatory tissue specimens showed expression of FAP. However, FAP was only present in 1/24 (4%) adenomas and absent in normal mucosa (0/28). Thus, FAP expression in CRC was significantly higher than in the other investigated groups. Within the CRC cohort, expression of FAP did not correlate with tumor stage, grading or the MSI status. However, it was observed that tumors exhibiting high immunohistochemical expression of Ki-67, CD3, p53, and β-Catenin showed a significantly higher incidence of FAP expression. Conclusion: In the crosstalk between tumor cells and TME, CAF play a key role in carcinogenesis and metastatic spread. Expression of FAP was detectable in the majority of CRC but nearly absent in precursor lesions and non-neoplastic, non-inflammatory tissue. This finding indicates that FAP has the potential to emerge as a target for new diagnostic and therapeutic concepts in CRC. Additionally, the association between FAP expression and other immunohistochemical parameters displays the interaction between different components of the TME and demands further investigation.
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Affiliation(s)
- K. Greimelmaier
- Institut für Pathologie, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - N. Klopp
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
| | - E. Mairinger
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
| | - M. Wessolly
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
| | - S. Borchert
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
| | - J. Steinborn
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
| | - K. W. Schmid
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
| | - J. Wohlschlaeger
- Institut für Pathologie, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - F. D. Mairinger
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Germany
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Borchert S, Mathilakathu A, Nath A, Wessolly M, Mairinger E, Kreidt D, Steinborn J, Walter RFH, Christoph DC, Kollmeier J, Wohlschlaeger J, Mairinger T, Brcic L, Mairinger FD. Cancer-Associated Fibroblasts Influence Survival in Pleural Mesothelioma: Digital Gene Expression Analysis and Supervised Machine Learning Model. Int J Mol Sci 2023; 24:12426. [PMID: 37569808 PMCID: PMC10419996 DOI: 10.3390/ijms241512426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
The exact mechanism of desmoplastic stromal reaction (DSR) formation is still unclear. The interaction between cancer cells and cancer-associated fibroblasts (CAFs) has an important role in tumor progression, while stromal changes are a poor prognostic factor in pleural mesothelioma (PM). We aimed to assess the impact of CAFs paracrine signaling within the tumor microenvironment and the DSR presence on survival, in a cohort of 77 PM patients. DSR formation was evaluated morphologically and by immunohistochemistry for Fibroblast activation protein alpha (FAP). Digital gene expression was analyzed using a custom-designed CodeSet (NanoString). Decision-tree-based analysis using the "conditional inference tree" (CIT) machine learning algorithm was performed on the obtained results. A significant association between FAP gene expression levels and the appearance of DSR was found (p = 0.025). DSR-high samples demonstrated a statistically significant prolonged median survival time. The elevated expression of MYT1, KDR, PIK3R1, PIK3R4, and SOS1 was associated with shortened OS, whereas the upregulation of VEGFC, FAP, and CDK4 was associated with prolonged OS. CIT revealed a three-tier system based on FAP, NF1, and RPTOR expressions. We could outline the prognostic value of CAFs-induced PI3K signaling pathway activation together with FAP-dependent CDK4 mediated cell cycle progression in PM, where prognostic and predictive biomarkers are urgently needed to introduce new therapeutic strategies.
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Affiliation(s)
- Sabrina Borchert
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | - Alexander Mathilakathu
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | - Alina Nath
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | - Michael Wessolly
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | - Elena Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | - Daniel Kreidt
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | | | - Robert F. H. Walter
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
| | - Daniel C. Christoph
- Department of Medical Oncology, Evangelische Kliniken Essen-Mitte, 45131 Essen, Germany;
| | - Jens Kollmeier
- Department of Pneumology, Helios Klinikum Emil von Behring, 14165 Berlin, Germany;
| | | | - Thomas Mairinger
- Department of Tissue Diagnostics, Helios Klinikum Emil von Behring, 14165 Berlin, Germany;
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria;
| | - Fabian D. Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (S.B.); (A.M.); (A.N.); (M.W.); (E.M.); (D.K.); (R.F.H.W.)
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Mathilakathu A, Wessolly M, Mairinger E, Uebner H, Kreidt D, Brcic L, Steinborn J, Greimelmaier K, Wohlschlaeger J, Schmid KW, Mairinger FD, Borchert S. Cancer-Associated Fibroblasts Regulate Kinase Activity in Mesothelioma Cell Lines via Paracrine Signaling and Thereby Dictate Cell Faith and Behavior. Int J Mol Sci 2022; 23:ijms23063278. [PMID: 35328699 PMCID: PMC8949651 DOI: 10.3390/ijms23063278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) has an infaust prognosis due to resistance to systemic treatment with platin-analoga. MPM cells modulate the immune response to their benefit. They release proinflammatory cytokines, such as TGF-ß, awakening resting fibrocytes that switch their phenotype into activated fibroblasts. Signaling interactions between cancer cells and cancer-associated fibroblasts (CAFs) play an integral part in tumor progression. This study aimed to investigate the role CAFs play in MPM progression, analyzing the impact this complex, symbiotic interaction has on kinase-related cell signaling in vitro. METHODS We simulated paracrine signaling in vitro by treating MPM cell lines with conditioned medium (CM) from fibroblasts (FB) and vice versa. NCI-H2052, MSTO-211H, and NCI-H2452 cell lines representing the three mayor MPM subtypes, while embryonal myofibroblast cell lines, IMR-90 and MRC-5, provide a CAFs-like phenotype. Subsequently, differences in proliferation rates, migratory behavior, apoptosis, necrosis, and viability were used as covariates for data analysis. Kinase activity of treated samples and corresponding controls were then analyzed using the PamStation12 platform (PamGene); Results: Treatment with myofibroblast-derived CM revealed significant changes in phosphorylation patterns in MPM cell lines. The observed effect differs strongly between the analyzed MPM cell lines and depends on the origin of CM. Overall, a much stronger effect was observed using CM derived from IMR-90 than MRC-5. The phosphorylation changes mainly affected the MAPK signaling pathway.; Conclusions: The factors secreted by myofibroblasts in fibroblasts CM significantly influence the phosphorylation of kinases, mainly affecting the MAPK signaling cascade in tested MPM cell lines. Our in vitro results indicate promising therapeutic effects by the use of MEK or ERK inhibitors and might have synergistic effects in combination with cisplatin-based treatment, improving clinical outcomes for MPM patients.
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Affiliation(s)
- Alexander Mathilakathu
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Michael Wessolly
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Elena Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Hendrik Uebner
- Department of Pulmonary Medicine, University Hospital Essen—Ruhrlandklinik, University of Duisburg Essen, 45147 Essen, Germany;
| | - Daniel Kreidt
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria;
| | - Julia Steinborn
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Kristina Greimelmaier
- Department of Pathology, Diakonissenkrankenhaus Flensburg, 24939 Flensburg, Germany; (K.G.); (J.W.)
| | - Jeremias Wohlschlaeger
- Department of Pathology, Diakonissenkrankenhaus Flensburg, 24939 Flensburg, Germany; (K.G.); (J.W.)
| | - Kurt Werner Schmid
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Fabian D. Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
| | - Sabrina Borchert
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (M.W.); (E.M.); (D.K.); (J.S.); (K.W.S.); (F.D.M.)
- Correspondence:
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Mathilakathu A, Borchert S, Wessolly M, Mairinger E, Beckert H, Steinborn J, Hager T, Christoph DC, Kollmeier J, Wohlschlaeger J, Mairinger T, Schmid KW, Walter RFH, Brcic L, Mairinger FD. Mitogen signal-associated pathways, energy metabolism regulation, and mediation of tumor immunogenicity play essential roles in the cellular response of malignant pleural mesotheliomas to platinum-based treatment: a retrospective study. Transl Lung Cancer Res 2021; 10:3030-3042. [PMID: 34430345 PMCID: PMC8350085 DOI: 10.21037/tlcr-21-201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/15/2021] [Indexed: 11/06/2022]
Abstract
Background Malignant pleural mesothelioma (MPM) is a rare malignant tumor associated with asbestos exposure, with infaust prognosis and overall survival below 20 months in treated patients. Platinum is still the backbone of the chemotherapy protocols, and the reasons for the rather poor efficacy of platinum compounds in MPM remain largely unknown. Therefore, we aimed to analyze differences in key signaling pathways and biological mechanisms in therapy-naïve samples and samples after chemotherapy in order to evaluate the effect of platinum-based chemotherapy. Methods The study cohort comprised 24 MPM tumor specimens, 12 from therapy-naïve and 12 from patients after platinum-based therapy. Tumor samples were screened using the NanoString nCounter platform for digital gene expression analysis with an appurtenant custom-designed panel comprising a total of 366 mRNAs covering the most important tumor signaling pathways. Significant pathway associations were identified by gene set enrichment analysis using the WEB-based GEne SeT AnaLysis Toolkit (WebGestalt) Results We have found reduced activity of TNF (normalized enrichment score: 2.03), IL-17 (normalized enrichment score: 1.93), MAPK (normalized enrichment score: 1.51), and relaxin signaling pathways (normalized enrichment score: 1.42) in the samples obtained after platinum-based therapy. In contrast, AMPK (normalized enrichment score: –1.58), mTOR (normalized enrichment score: –1.50), Wnt (normalized enrichment score: –1.38), and longevity regulating pathway (normalized enrichment score: –1.31) showed significantly elevated expression in the same samples. Conclusions We could identify deregulated signaling pathways due to a directed cellular response to platinum-induced cell stress. Our results are paving the ground for a better understanding of cellular responses and escape mechanisms, carrying a high potential for improved clinical management of patients with MPM.
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Affiliation(s)
- Alexander Mathilakathu
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Sabrina Borchert
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Michael Wessolly
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Elena Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Hendrik Beckert
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, Germany
| | - Julia Steinborn
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Thomas Hager
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Daniel C Christoph
- Department of Medical Oncology, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Jens Kollmeier
- Department of Pneumology, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Jeremias Wohlschlaeger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Thomas Mairinger
- Department of Tissue Diagnostics, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Kurt Werner Schmid
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Robert F H Walter
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Fabian D Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, Essen, Germany
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Kolberg-Liedtke C, Hussein S, Bankfalvi A, Steinborn J, Ting S, Bittner AK, Hoffmann O, Pott B, Hannig CV, Wetzig S, Kolberg HC. The role of Ki67 in involved lymph nodes as a predictive biomarker for response to neoadjuvant chemotherapy in patients with early breast cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e12553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12553 Background: Neoadjuvant chemotherapy (NACT) is a standard in early breast cancer (EBC) with an unfavorable tumor biology and pathologic complete remission (pCR) after NACT is indicating an improved prognosis. Ki67 is well established as a prognostic and predictive biomarker in early breast cancer and the association of high Ki67-results in breast tumors at the time of initial diagnosis and pCR after NACT is used for decision making for versus against NACT in daily routine in many countries. Data about associations of Ki67 in involved lymph nodes and response to NACT are missing. Methods: We conducted a retrospective analysis among patients in our database who had received NACT for EBC, had lymph node involvement verified by core cut biopsy and available data for pCR, age, estrogen and progesterone receptor (ER, PR) status, HER2neu status, Ki67 in the breast tumor and grading. Patients treated in clinical studies were excluded. Ki67 was measured in the archived material of biopsies from involved lymph nodes and the association between Ki67 in involved lymph nodes and response to neoadjuvant chemotherapy was analyzed. Results: 52 patients were included with regard to the criteria mentioned above, 21 had to be excluded because there was not enough lymph node biopsy material for Ki67 analysis. 7 (22.6) of the remaining 31 patients achieved a pCR and 11 (35.5%) achieved a nodal conversion to ypN0. Median Ki67 was 35% [3%, 85%] in involved lymph nodes and 40% [10%, 90%] in the breast. There was no significant correlation (Spearman Rho) between Ki67 in involved lymph nodes and pCR whereas there was for Ki67 in the breast (p = 0.046). The ROC-analysis resulted in a cut-off of 47% with the highest sensitivity for Ki67 in lymph nodes regarding prediction of nodal conversion. An analysis with a cut-off of Ki67 in involved lymph nodes of 47% predicted a nodal conversion in 60% of the cases (Chi-Square and Fisher’s Exact test; p = 0.0049). Conclusions: Our analysis supports Ki67 as a strong predictive biomarker regarding pCR after neoadjuvant chemotherapy. Although high Ki67 expression in involved lymph nodes is significantly associated with nodal conversion, it does not add clinically meaningful information to Ki67 in the breast.
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Affiliation(s)
| | - Shady Hussein
- Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - Agnes Bankfalvi
- Department of Pathology, University of Duisburg-Essen, Essen, Germany
| | - Julia Steinborn
- Department of Pathology, University Hospital Essen, Essen, Germany
| | - Saskia Ting
- Institute of Pathology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Ann-Kathrin Bittner
- Department of Obstetrics and Gynecology, University of Essen, Essen, Germany
| | - Oliver Hoffmann
- Department of Obstetrics and Gynecology, University Hospital Essen, Essen, Germany
| | - Birgit Pott
- Onkologische Gemeinschaftspraxis Bottrop, Bottrop, Germany
| | | | - Sarah Wetzig
- Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany
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Brcic L, Mathilakathu A, Walter RFH, Wessolly M, Mairinger E, Beckert H, Kreidt D, Steinborn J, Hager T, Christoph DC, Kollmeier J, Mairinger T, Wohlschlaeger J, Schmid KW, Borchert S, Mairinger FD. Digital Gene Expression Analysis of Epithelioid and Sarcomatoid Mesothelioma Reveals Differences in Immunogenicity. Cancers (Basel) 2021; 13:1761. [PMID: 33917061 PMCID: PMC8067687 DOI: 10.3390/cancers13081761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 02/08/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive malignancy associated with asbestos exposure. Median survival ranges from 14 to 20 months after initial diagnosis. As of November 2020, the FDA approved a combination of immune checkpoint inhibitors after promising intermediate results. Nonetheless, responses remain unsatisfying. Adequate patient stratification to improve response rates is still lacking. This retrospective study analyzed formalin fixed paraffin embedded specimens from a cohort of 22 MPM. Twelve of those samples showed sarcomatoid, ten epithelioid differentiation. Complete follow-up, including radiological assessment of response by modRECIST and time to death, was available with reported deaths of all patients. RNA of all samples was isolated and subjected to digital gene expression pattern analysis. Our study revealed a notable difference between epithelioid and sarcomatoid mesothelioma, showing differential gene expression for 304/698 expressed genes. Whereas antigen processing and presentation to resident cytotoxic T cells as well as phagocytosis is highly affected in sarcomatoid mesothelioma, cell-cell interaction via cytokines seems to be of greater importance in epithelioid cases. Our work reveals the specific role of the immune system within the different histologic subtypes of MPM, providing a more detailed background of their immunogenic potential. This is of great interest regarding therapeutic strategies including immunotherapy in mesothelioma.
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Affiliation(s)
- Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria;
| | - Alexander Mathilakathu
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Robert F. H. Walter
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Michael Wessolly
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Elena Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Hendrik Beckert
- Department of Pulmonary Medicine, University Hospital Essen—Ruhrlandklinik, 45239 Essen, Germany;
| | - Daniel Kreidt
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Julia Steinborn
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Thomas Hager
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Daniel C. Christoph
- Department of Medical Oncology, Evang. Kliniken Essen-Mitte, 45136 Essen, Germany;
| | - Jens Kollmeier
- Department of Pneumology, Helios Klinikum Emil von Behring, 14165 Berlin, Germany;
| | - Thomas Mairinger
- Department of Tissue Diagnostics, Helios Klinikum Emil von Behring, 14165 Berlin, Germany;
| | | | - Kurt Werner Schmid
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Sabrina Borchert
- Institute of Pathology, University Hospital Essen, University of Duisburg Essen, 45147 Essen, Germany; (A.M.); (R.F.H.W.); (M.W.); (E.M.); (D.K.); (J.S.); (T.H.); (K.W.S.); (S.B.)
| | - Fabian D. Mairinger
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8010 Graz, Austria;
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Steinborn J. [Hazards caused by tetrachloroethylene (G17), tetrachloroethane and pentachloroethane (G 18)]. Zentralbl Arbeitsmed Arbeitsschutz Prophyl 1978; 28:229-32. [PMID: 706863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Steinborn J. [Demands on the laboratory of the industrial medicine physician]. Zentralbl Arbeitsmed Arbeitsschutz Prophyl 1976; 26:49-55. [PMID: 961135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Taylor DB, Steinborn J, Lu TC. Ion exchange processes at the neuromuscular junction of voluntary muscle. J Pharmacol Exp Ther 1970; 175:213-27. [PMID: 5471448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Steinborn J. [Liver damage caused by solvents and their laboratory diagnostic coverage]. Zentralbl Arbeitsmed 1969; 19:168-74. [PMID: 5800282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Steinborn J. [Damage of the hematopoietic system by solvents and its recognition by laboratory diagnosis]. Zentralbl Arbeitsmed 1968; 18:312-9. [PMID: 5731007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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